Acute combined demyelination of CNS and PNS: a case report

Acute disseminated encephalomyelitis [ADEM] and Guillain-Barre syndrome [GBS] are both para infectious demyelinating disorders. While ADEM almost always affects the CNS, GBS affects the PNS. The combined demyelinating process - demyelination of both upper motor neuron [UMN] and lower motor neuron [LMN] - occurs very rarely. Here we report a case of severe combined peripheral and central demyelination, in which the former disorder was preceded by the latter

Acute disseminated encephalomyelitis in a 5-month old infant

This article reports on an 5-month-old infant who was admitted to our hospital for prolonged fever, focal status epilepticus and encephalopathy. Brain magnetic resonance imaging [MRI] demonstrated a single hyperintense lesion in right putamen in T2-weighted images. A diagnosis of acute disseminated encephalomyelitis was made based on the clinical features, treatment response and clinical course. An executive literature review revealed a few cases under the age of one year .This patient is the youngest are who is reported from Iran

Acute disseminated encephalomyelitis in childhood; epidemiologic, clinical, and laboratory features

Acute disseminated encephalomyelitis [ADEM], which occurs spontaneously or after systemic viral infection and vaccination mostly affects children. This study aims at describing the epidemiologic, clinical, neuroimaging, laboratory features, treatment and outcome in children who diagnosed as having ADEM and admitted in a referral center in Tehran. This descriptive prospective study was conducted on patients with a diagnosis of ADEM over a period of 30 months, between Sep 2003 and Mar 2006, admitted to the neurology ward of Mofid Pediatric Hospital. All these patients were visited in regular follow-up every 6 months for two years. Eighteen patients with the mean age of 6 years [range 5 months - 12 years] were studied. No sex predominance was noted. Sixty-one percent had prodromal illness, and two patients had been vaccinated before the illness. Thirteen [72%] patients presented in fall or winter. Motor deficits and cranial nerve palsy were the most common features, which had occurred in 13 [72%] patients. Abnormal findings in cerebrospinal fluid evaluation were detected in 33% of the patients. Brain computed tomography was normal in all but one patient. Electroencephalograms done in nine patients were normal in 54%. Magnetic resonance imaging showed lesions were most commonly in the subcortical and periventricular areas [76%]. Nine [50%] patients were treated with corticosteroids and intravenous immunoglobulin. The mortality rate was 5.5%, and the relapse occurred only in one case. In two-thirds of the patients, prognosis for complete recovery was excellent. Childhood ADEM is a benign condition, affecting both sexes equally. Recurrent infections have been its common cause in our center

[Isolation of carbapenem resistant Acinetobacter baumannii [CRAB] strains from patients and equipments of Intensive care units [ICUs] at Qazvin between 2005-2006]

Acinetobacter spp. are gram negative aerobic bacteria that grow easily on routine bacterial culture media. The carbapenem resistant Acinetobacter baumannii was firstly recognized as causative of nosocomial infection outbreak in 1991 and reported from different countries sine then. We designed this study to determine the prevalence of carbapenem resistant isolates of Acinetobacter baumannii from patients and equipments at intensive care units [ICUs] of Qazvin University hospitals. During November 2005 to October 2006, 400 samples were collected from patients and equipments of ICUs of University hospitals in Qazvin. The specimens were cultured on MacConkey agar and isolated bacteria were identified using conventional bacteriological methods. Carbapenem resistant isolates were detected using disk containing imipenem in Kerby Bauer method. Of 400 samples cultured from ICUs, 15 [3.15%] yielded A. baumannii. A total of 4 isolates [26.6%] were resistant to imipenem [CRAB]. Acinetobacter baumannii can be isolated from patients and equipments in ICUs of Qazvin University hospitals. The rate of carbapenem resistance is high among isolated strains

Isolation and identification of Legionnaire's disease agents from the medical equipments and environmental water sources

Background: The legionellaceae family has a single genus legionella which is a major cause of respiratory disease in human. These agents are water - born organisms with a wide distribution in natural and artificial environmental water supplies. Transmission to human may occur through contaminated aerosols

Objective: This study was performed to isolate and identify determine the legionnaire's disease agents from the medical equipments and environmental water sources. 210 samples were collected from hospitals and other aquatic sources in Ahwaz. The samples were examined for legionella bacteriology

Findings: The results indicated that the legionella were present in 14 out of 2 10 samples. Using biochemical tests, 9 serogroups of legionella species were recognized as pneumophila and the remaining 5 serogroups were reported as other legionella species

Conclusion: It seems that legionellas exist at the location of the sampling areas. Recognition of different serogroups of these bacteria needs more epidemiological studies